Journal of Pathology and Translational Medicine

Case Study

Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: Soyeon Choi, Ji Hye Kim, Kyungbin Kim, Misung Kim, Hye Jeong Choi, Young Min Kim, Jae Hee Suh, Min Jung Seo, Hee Jeong Cha; J Pathol Transl Med. 2020;54(4):340-345. Published online April 15, 2020; DOI: https://doi.org/10.4132/jptm.2020.03.18

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Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), is one of the specific type of low-grade B-cell lymphoma not infrequently found worldwide. It typically involves mucosal sites such as stomach and conjunctiva; however, primary hepatic MALT lymphoma has been extremely rarely reported. We describe a case of hepatic MALT lymphoma in a 70-year-old male patient who underwent left hepatectomy due to the incidentally detected liver masses at a medical checkup. The resected specimen revealed multinodular masses consisting of small-to-intermediate-sized lymphoid cells with serpentine pattern and focal lymphoepithelial lesions. The tumor cells were diffusely positive for CD20 and Bcl-2 but negative for CD3, CD10, CD5, CD23, CD43, and cyclinD1. The Ki-67 labeling index was 10% and immunoglobulin heavy chain gene rearrangement study confirmed monoclonal proliferation. In this paper, we discuss several unique clinicopathologic characteristics which will be helpful to the differential diagnosis of hepatic MALT lymphoma.

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“Speckled Enhancement” on Gd-EOB-DTPA Enhanced MR Imaging of Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma
Ryota Hyodo, Yasuo Takehara, Ayumi Nishida, Masaya Matsushima, Shinji Naganawa
Magnetic Resonance in Medical Sciences.2023; 22(3): 273. CrossRef
Primary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue lymphoma treated by laparoscopic partial hepatectomy: a case report
Keisuke Okura, Satoru Seo, Hironori Shimizu, Hiroto Nishino, Tomoaki Yoh, Ken Fukumitsu, Takamichi Ishii, Koichiro Hata, Hironori Haga, Etsuro Hatano
Surgical Case Reports.2023;[Epub] CrossRef
Incidental Findings in Pediatric Patients: How to Manage Liver Incidentaloma in Pediatric Patients
Andrius Cekuolis, Dagmar Schreiber-Dietrich, Rasa Augustinienė, Heike Taut, Judy Squires, Edda L. Chaves, Yi Dong, Christoph F. Dietrich
Cancers.2023; 15(8): 2360. CrossRef
Primary hepatic mucosa‐associated lymphoid tissue lymphoma: Case report and literature review
Wing Yu Lau, Kit‐Man Ho, Fiona Ka‐Man Chan, Shi Lam, Kai‐Chi Cheng
Surgical Practice.2022; 26(1): 56. CrossRef
18F-FDG Versus 68Ga-FAPI PET/CT in Visualizing Primary Hepatic Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue
Yizhen Pang, Long Zhao, Qihang Shang, Tinghua Meng, Haojun Chen
Clinical Nuclear Medicine.2022; 47(4): 375. CrossRef
Primary hepatopancreatobiliary lymphoma: Pathogenesis, diagnosis, and management
Qianwen Wang, Kangze Wu, Xuzhao Zhang, Yang Liu, Zhouyi Sun, Shumei Wei, Bo Zhang
Frontiers in Oncology.2022;[Epub] CrossRef
Positive effect of Bifidobacterium animalis subsp. lactis VHProbi YB11 in improving gastrointestinal movement of mice having constipation
Hongchang Cui, Qian Wang, Congrui Feng, Chaoqun Guo, Jingyan Zhang, Xinping Bu, Zhi Duan
Frontiers in Microbiology.2022;[Epub] CrossRef
A case of primary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue (MALT) lymphoma treated by radiofrequency ablation (RFA), and a literature review
Zhe Xu, Chong Pang, Jidong Sui, Zhenming Gao
Journal of International Medical Research.2021; 49(3): 030006052199953. CrossRef

Original Article

Programmed death-ligand 1 expression and its correlation with clinicopathological parameters in gallbladder cancer: Ji Hye Kim, Kyungbin Kim, Misung Kim, Young Min Kim, Jae Hee Suh, Hee Jeong Cha, Hye Jeong Choi; J Pathol Transl Med. 2020;54(2):154-164. Published online February 10, 2020; DOI: https://doi.org/10.4132/jptm.2019.11.13

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Abstract PDF

Background
Immunomodulatory therapies targeting the interaction between programmed cell death protein 1 and programmed death-ligand 1 (PD-L1) have become increasingly important in anticancer treatment. Previous research on the subject of this immune response has established an association with tumor aggressiveness and a poor prognosis in certain cancers. Currently, scant information is available on the relationship between PD-L1 expression and gallbladder cancer (GBC).
Methods
We investigated the expression of PD-L1 in 101 primary GBC cases to determine the potential association with prognostic impact. PD-L1 expression was immunohistochemically assessed using a single PD-L1 antibody (clone SP263). Correlations with clinicopathological parameters, overall survival (OS), or progression- free survival (PFS) were analyzed.
Results
PD-L1 expression in tumor cells at cutoff levels of 1%, 10%, and 50% was present in 18.8%, 13.8%, and 7.9% of cases. Our study showed that positive PD-L1 expression at any cutoff was significantly correlated with poorly differentiated histologic grade and the presence of lymphovascular invasion (p < .05). PD-L1 expression at cutoff levels of 10% and 50% was significantly positive in patients with perineural invasion, higher T categories, and higher pathologic stages (p < .05). Additionally, there was a significant association noted between PD-L1 expression at a cutoff level of 50% and worse OS or PFS (p = .049 for OS, p = .028 for PFS). Other poor prognostic factors included histologic grade, T category, N category, pathologic stage, lymphovascular invasion, perineural invasion, growth pattern, and margin of resection (p < .05).
Conclusions
The expression of PD-L1 in GBC varies according to cutoff level but is valuably associated with poor prognostic parameters and survival. Our study indicates that the overexpression of PD-L1 in GBC had a negative prognostic impact.

Citations

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Lacking Immunotherapy Biomarkers for Biliary Tract Cancer: A Comprehensive Systematic Literature Review and Meta-Analysis
Giorgio Frega, Fernando P. Cossio, Jesus M. Banales, Vincenzo Cardinale, Rocio I. R. Macias, Chiara Braconi, Angela Lamarca
Cells.2023; 12(16): 2098. CrossRef
Gallbladder carcinomas: review and updates on morphology, immunohistochemistry, and staging
Whayoung Lee, Vishal S. Chandan
Human Pathology.2023; 132: 149. CrossRef
Prognostic Relevance of PDL1 and CA19-9 Expression in Gallbladder Cancer vs. Inflammatory Lesions
Neetu Rawal, Supriya Awasthi, Nihar Ranjan Dash, Sunil Kumar, Prasenjit Das, Amar Ranjan, Anita Chopra, Maroof Ahmad Khan, Sundeep Saluja, Showket Hussain, Pranay Tanwar
Current Oncology.2023; 30(2): 1571. CrossRef
Identification of genes associated with gall bladder cell carcinogenesis: Implications in targeted therapy of gall bladder cancer
Ishita Ghosh, Ruma Dey Ghosh, Soma Mukhopadhyay
World Journal of Gastrointestinal Oncology.2023; 15(12): 2053. CrossRef
CD73 and PD-L1 as Potential Therapeutic Targets in Gallbladder Cancer
Lu Cao, Kim R. Bridle, Ritu Shrestha, Prashanth Prithviraj, Darrell H. G. Crawford, Aparna Jayachandran
International Journal of Molecular Sciences.2022; 23(3): 1565. CrossRef
Evolving Role of Immunotherapy in Advanced Biliary Tract Cancers
Sandra Kang, Bassel F. El-Rayes, Mehmet Akce
Cancers.2022; 14(7): 1748. CrossRef
Novel immune scoring dynamic nomograms based on B7-H3, B7-H4, and HHLA2: Potential prediction in survival and immunotherapeutic efficacy for gallbladder cancer
Chao Lv, Shukun Han, Baokang Wu, Zhiyun Liang, Yang Li, Yizhou Zhang, Qi Lang, Chongli Zhong, Lei Fu, Yang Yu, Feng Xu, Yu Tian
Frontiers in Immunology.2022;[Epub] CrossRef
PD-1 inhibitors plus nab-paclitaxel-containing chemotherapy for advanced gallbladder cancer in a second-line setting: A retrospective analysis of a case series
Sirui Tan, Jing Yu, Qiyue Huang, Nan Zhou, Hongfeng Gou
Frontiers in Oncology.2022;[Epub] CrossRef
Expression of HER2 and Mismatch Repair Proteins in Surgically Resected Gallbladder Adenocarcinoma
You-Na Sung, Sung Joo Kim, Sun-Young Jun, Changhoon Yoo, Kyu-Pyo Kim, Jae Hoon Lee, Dae Wook Hwang, Shin Hwang, Sang Soo Lee, Seung-Mo Hong
Frontiers in Oncology.2021;[Epub] CrossRef
Programmed Death Ligand-1 (PD-L1) Is an Independent Negative Prognosticator in Western-World Gallbladder Cancer
Thomas Albrecht, Fritz Brinkmann, Michael Albrecht, Anke S. Lonsdorf, Arianeb Mehrabi, Katrin Hoffmann, Yakup Kulu, Alphonse Charbel, Monika N. Vogel, Christian Rupp, Bruno Köhler, Christoph Springfeld, Peter Schirmacher, Stephanie Roessler, Benjamin Goep
Cancers.2021; 13(7): 1682. CrossRef
Immune Microenvironment in Gallbladder Adenocarcinomas
Pallavi A. Patil, Kara Lombardo, Weibiao Cao
Applied Immunohistochemistry & Molecular Morphology.2021; 29(8): 557. CrossRef
Molecular Targets and Emerging Therapies for Advanced Gallbladder Cancer
Matteo Canale, Manlio Monti, Ilario Giovanni Rapposelli, Paola Ulivi, Francesco Giulio Sullo, Giulia Bartolini, Elisa Tiberi, Giovanni Luca Frassineti
Cancers.2021; 13(22): 5671. CrossRef
Overview of current targeted therapy in gallbladder cancer
Xiaoling Song, Yunping Hu, Yongsheng Li, Rong Shao, Fatao Liu, Yingbin Liu
Signal Transduction and Targeted Therapy.2020;[Epub] CrossRef

Letter to the Editor

Perineural Involvement in Benign Mixed Tumor: Se Jin Jung, Jong Cheol Lee, Hye Jeong Choi, Hee Jeong Cha, Young Min Kim, Young Wha Koh, Jae Hee Suh; Korean J Pathol. 2013;47(5):403-404. Published online October 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.5.403

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Citations

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Benign Pleomorphic Adenoma in the Facial Nerve
Gemma E. Hogg, Richard A. Steven, Patrick M. Spielmann
Ear, Nose & Throat Journal.2020; 99(6): 361. CrossRef
Benign pleomorphic adenoma of minor salivary gland showing perineural invasion: a rare entity
Rahul Jayaram, Dipen Patel, Vijay Santhanam
British Journal of Oral and Maxillofacial Surgery.2015; 53(1): 81. CrossRef

Case Reports

Acute Appendicitis Associated with Aspergillosis in a Leukemia Patient: A Case Report.: Bong Hee Park, Jae Hee Suh, Hye Jeong Choi, Hee Jeong Cha, Chang Woo Nam, Young Min Kim; Korean J Pathol. 2010;44(3):330-332.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.330

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Abstract PDF

Herein we describe a rare case of acute appendicitis associated with localized aspergillosis in an 8-year-old boy with acute lymphoblastic leukemia. During chemotherapy, the patient complained of mild abdominal pain in the peri-umbilical area and displayed an increased C-reactive protein level. Abdominal ultrasonography disclosed appendicitis and consequently an appendectomy was done. Histologically, acute appendicitis and Aspergillus hyphae were identified in the lumen and necrotic mucosa. However, there was no evidence of systemic aspergillosis. While aspergillosis is a common fungal infection in immunocompromised patients treated with chemotherapy, acute appendicitis associated with localized aspergillosis without systemic infection is a very rare occurrence.

Citations

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A scoping review on acute gastrointestinal surgical complications in immunocompromised pediatric patients
Tarek Bou Dargham, Mohamad Bahij Moumneh, Christine Atallah, Ahmad Zaghal
Annals of Pediatric Surgery.2022;[Epub] CrossRef
Acute isolated Aspergillus appendicitis in pediatric leukemia
Yutaro Yada, Yuhki Koga, Hiroaki Ono, Yoshitomo Motomura, Genshiro Esumi, Kenichi Kohashi, Yasunori Muraosa, Katsuhiko Kamei, Toshiharu Matsuura, Yoshinao Oda, Shouichi Ohga
Journal of Infection and Chemotherapy.2020; 26(11): 1229. CrossRef
Isolated Acute Appendicitis Caused by Aspergillu s in a Patient Who Underwent Lung Transplantation: A Case Report
H.S. Kim, H.J. Yeo, D.H. Shin, W.H. Cho, D. Kim
Transplantation Proceedings.2018; 50(4): 1199. CrossRef
Fungal Appendicitis in Immunocompromised Children. Indications and Contraindications for Laparoscopic Appendectomy: A Report on 2 Successful Cases
Veronica Carlini, Valeria Calcaterra, Nunzia Decembrino, Laura Rubert, Noemi Pasqua, Mattia Novario, Marco Lucioni, Marco Brunero, Gloria Pelizzo
Journal of Pediatric Hematology/Oncology.2016; 38(7): 581. CrossRef
Characteristic clinical features ofAspergillusappendicitis: Case report and literature review
Mihajlo Gjeorgjievski
World Journal of Gastroenterology.2015; 21(44): 12713. CrossRef

Intraductal Papillary Mucinous Tumor Simultaneously Involving the Liver and Pancreas: A Case Report.: Bong Hee Park, Jae Hee Suh, Hee Jeong Cha, Young Min Kim, Hye Jeong Choi; Korean J Pathol. 2010;44(1):83-86.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.83

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Abstract PDF

We describe here a 67-year-old man who was diagnosed with a rare case of intraductal papillary mucinous tumors that occurred simultaneously in the liver and pancreas. Abdominal computed tomography showed a tubular and cystic dilatation of the pancreatic duct in the pancreas tail, which suggested an intraductal papillary mucinous tumor (IPMT), and multiple intrahepatic duct stones. The patient underwent a distal pancreatectomy with splenectomy and a lateral segmentectomy of the liver. Microscopic examination showed an intraductal papillary mucinous neoplasms of borderline malignancy in the pancreas and a non-invasive intraductal papillary mucinous tumor with moderate dysplasia of the bile duct. Although several cases of intraductal papillary mucinous neoplasm of the liver (IPNL) without any pancreatic association have been described, the simultaneous presentation of both IPMT of the pancreas and IPNL is very rare. The patient has been doing well for 10 months postoperatively.

Citations

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Reoperation for heterochronic intraductal papillary mucinous neoplasm of the pancreas after bile duct neoplasm resection: A case report
Gang Xiao, Tao Xia, Yi-Ping Mou, Yu-Cheng Zhou
World Journal of Gastrointestinal Surgery.2023; 15(7): 1542. CrossRef
Intraductal papillary neoplasm of the bile duct: The new frontier of biliary pathology
Federico Mocchegiani, Paolo Vincenzi, Grazia Conte, Daniele Nicolini, Roberta Rossi, Andrea Benedetti Cacciaguerra, Marco Vivarelli
World Journal of Gastroenterology.2023; 29(38): 5361. CrossRef
Multicentric recurrence of intraductal papillary neoplasm of bile duct after spontaneous detachment of primary tumor: A case report
Hiroki Fukuya, Akifumi Kuwano, Shigehiro Nagasawa, Yusuke Morita, Kosuke Tanaka, Masayoshi Yada, Akihide Masumoto, Kenta Motomura
World Journal of Clinical Cases.2022; 10(3): 1000. CrossRef
Co-occurrence of IPMN and malignant IPNB complicated by a pancreatobiliary fistula: A case report and review of the literature
Xu Ren, Chun-Lan Zhu, Xu-Fu Qin, Hong Jiang, Tian Xia, Yong-Ping Qu
World Journal of Clinical Cases.2019; 7(1): 102. CrossRef
Synchronous pancreatic adenocarcinoma and intrahepatic cholangiocarcinoma arising in the context of intraductal papillary neoplasms
Anmol Bansal, Swan N. Thung, Hongfa Zhu, Myron Schwartz, Sara Lewis
Clinical Imaging.2016; 40(5): 897. CrossRef

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis of Mandible: A Case Report.: Sang Ryung Lee, Jae Hee Suh, Hee Jung Cha, Young Min Kim, Hye Jeong Choi; Korean J Pathol. 2010;44(1):106-109.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.106

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Abstract PDF

We present a case of mandibular involvement with Langerhans cell histiocytosis (LCH), diagnosed by ultrasound-guided aspiration and subsequently confirmed by incisional biopsy and immunohistochemistry in an eight-year-old boy. The cytologic findings included the presence of characteristic Langerhans cells of both mononucleate and multinucleate form. Diagnostic confirmation was obtained by immunopositivity for S-100 protein and CD1a of Langerhans histiocytes on paraffin-embedded sections obtained during incisional biopsy of the right mandibular area. By reporting a case of childhood LCH, we correlate the cytologic findings with histologic features and discuss the role of aspiration cytologic diagnosis in such a rare and cytomorphologically characteristic case.

Citations

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Bronchial Washing Cytology of Pulmonary Langerhans Cell Histiocytosis: A Case Report
Taeyeong Kim, Hyeong Ju Kwon, Minseob Eom, Sang Wook Kim, Min Hi Sin, Soon-Hee Jung
Journal of Pathology and Translational Medicine.2017; 51(4): 444. CrossRef

Original Article

Quality Assurance of Intraoperative Consultation Review Analysis of 2,392 frozen sections.: Dong Hae Chung, Jae Hee Suh, On Ja Kim; Korean J Pathol. 1997;31(4):332-341.

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Abstract PDF: A retrospective quality assurance study of intraoperative consultation (frozen section) was carried out to assess the accuracy and to determine the reasons of discordance. Of 14,977 surgical pathology cases accessioned over a 6-month period in Asan Medical Center, frozen sections were done on 1,270 (8.5%) patients and 2,392 frozen sections (1.88 frozen sections/case) were performed. Discordance was noted in 106 cases (4.4%) and diagnosis was deferred in 26 cases (1.1%). All deferred cases were reviewed with the result of 53.8% justified and 46.2% unjustified. The discordant cases were divided into three categories as to their clinical significances: category A (no affect on patient care) 61.3%, B (minimal affect) 9.4%, and C (major affect) 29.2%. Of 31 category C cases, 7 cases were false positive and 24 cases were false negative. Misinterpretation (70.8%) was the leading cause of discordance, followed by sampling error (15.1%), failure to identify lesion (8.5%), and technical problem (5.7%). More than one-third (35.8%) of all discordances were of central nervous system cases. Total central nervous system cases were 403 (16.8%) with a significantly higher disordance rate (9.8%) and deferral rate (2.5%) in comparison to the other cases with 3.4% discordance rate and 0.8% deferral rate. There were 43 colorectal cancer cases of intraoperative consultation for adequacy of resectional margins. The surgical margins were between 0.4 cm and 28 cm (mean: 6.7 cm) away from the tumor and there was no tumor-positive case. The study indicates surgical pathology should 1) promote interpretative skills in cases involving minute fragments of neurosurgical cases, 2) defer the diagnosis and ask for more tissue on inadequate or inappropriate specimens and 3) give only gross opinions without unnecessary frozen section procedures in the event of simple, clear-cut cases.

Case Reports

Clear Cell Ependymoma.: Jae Hee Suh, Seung Mo Hong, In Chul Lee; Korean J Pathol. 1997;31(4):383-387.

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Abstract PDF: The clear cell variant of ependymoma is a rare, recently described, intracranial tumor which is composed of clear neoplastic ependymal cells. Clear cell ependymomas may share characteristic histologic features of oligodendrogliomas or central neurocytomas; striking nuclear uniformity, perinuclear halos, and numerous angulated capillaries. In contrast to oligodendrogliomas, however, clear cell ependymomas are noninfiltrating tumors with sharp boundaries. Perivascular pseudorosette formation is frequent. Oligodendrogliomas are usually nonreactive for GFAP compared to diffuse immunoreactivity of clear cell ependymoma. Central neurocytomas may also be differentiated by their immunoreactivity for synaptophysin. This is a case of clear cell ependymoma in a 40-year-old man. By computed tomography and magnetic resonance imaging scans, a well circumscribed cystic tumor with mural nodule was demonstrated in the right frontal lobe. It was 6cm in diameter and well enhanced. Histologically, it was sharply demarcated from the brain parenchyma. The cystic wall was lined by atypical ependymal cells, which "transformed" to clear cells in the solid area. The cells had uniform nuclei and perinuclear halos. Mitotic figures and necrotic foci were focally present. The cells were immunoreactive for glial fibrillary acidic protein (GFAP), while synaptophysin was negative. Electron microscopy revealed densely packed polyheadral cells with scant organelles and well developed intercellular junctions.

Malignant Rhabdoid Tumor of the Cerebellum in an Adult: A case report.: Young Min Kim, Jae Hee Suh, Tae Sook Kim, Shin Kwang Khang; Korean J Pathol. 1998;32(6):460-465.

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Abstract: Malignant rhabdoid tumor (MRT) is a rare and highly aggressive neoplasm of infancy and childhood. Although it was originally described and most frequently reported in the kidney, it may occur in various extra-renal sites such as the liver, thymus, and soft tissue. In the last decade primary central nervous system (CNS) MRTs have been reported in both the supra- and infratentorial compartments. Patients with CNS MRT were generally below the age of two and reports in adults are extremely rare. This is a case of primary cerebellar MRT in a 24-year-old woman, who had presented with intermittent headache, vocal cord palsy, and cerebellar dysfunctions such as abnormal finger to nose test and tandem gait. By magnetic resonance imaging scan, a well-enhancing solid mass was demonstrated at the posterior fossa filling the 4th ventricle, which extended into the medulla and cervical cord via the foramen of Magendie. Histologically, the monotonous polygonal tumor cells were arranged in diffuse sheet with occasional hemorrhagic necrosis. The nuclei were vesicular and eccentrically located due to eosinophilic, PAS-positive, intracytoplasmic inclusions with prominent nucleoli. They were diffusely or focally immunoreactive for vimentin, neurofilament, cytokeratin, GFAP, synaptophysin, and smooth muscle actin, while epithelial membrane antigen and desmin were negative. Ultrastructurally, the polyhedral tumor cells were densely packed with primitive intercellular junctions. Scanty fibrillar intermediate filaments were intermingled with cellular organelles. Postoperatively, craniospinal irradiation and systemic chemotherapy have been done and she has been free of tumor recurrence during the 13 months' follow-up periods.

Original Articles

Expression of Phospholipase C-gamma1 and gamma2 in Non-Hodgkin's and Hodgkin's Lymphoma.: Dae Woon Eom, Sung Sook Kim, Yeong Ju Woo, Jae Hee Suh, Jooryung Huh, Ae Ran Paik, Jae Ho Kim, Sung Ho Ryu, Pann Ghill Suh; Korean J Pathol. 2000;34(2):113-118.

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Abstract PDF: Phospholipase C (PLC) plays a role in ligand-mediated signal transduction for cellular activity such as proliferation and differentiation. A recent observation that PLC- gamma1 is highly expressed in some kinds of human cancer tissue supports the view that PLC-gamma1 may be involved in proliferation and carcinogenesis. PLC-gamma2 is known to be involved in B cell differentiation and maturation. However, there have been few studies about the expressions of PLC-gamma1 and gamma2 in human lymphoid malignancy. In the present study, we examined the contents of PLC-gamma1 and gamma2 in 10 cases of B cell, 10 cases of T cell non-Hodgkin's lymphoma and 5 cases of Hodgkin's lymphoma to find out whether these enzymes play any role in the carcinogenesis by immunohistochemistry and immunoprecipitation. Immunoprecipitation analysis revealed that in contrast to increased expression of PLC-gamma2 only in B cell lymphoma, a considerably higher level of PLC-gamma1 was detected in both B and T cell lymphoma. Immunohistochemical finding confirmed this observation. PLC-gamma1 and PLC-gamma2 were expressed in the cytoplasm of most tumor cells. PLC-gamma2 was also expressed in mature B cells, while PLC-gamma1 was not expressed in reactive non-tumor cells. These results suggest that PLC-gamma1 mediated signal transduction implicates a significant role in the carcinogenesis of all types of lymphoid tissue, and PLC-gamma2 may play a role in the carcinogenesis of B cell lymphoma as well as B cell differentiation.

Altered Expression of Tissue Inhibitor of Matrix Metalloproteinase-2 in Complicated Mice Heart Secondary to Experimentally Induced Viral Myocarditis.: Sung Sook Kim, Dae Woon Eom, Yeong Ju Woo, Jae Hee Suh, Jooryung Huh, Young Me Hong, Inpyo Choi; Korean J Pathol. 2001;35(3):196-200.

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Abstract PDF: BACKGROUND
The pathogenesis of transition from viral myocarditis to dilated cardiomyopathy is elusive, although the incidence of dilated cardiomyopathy in human is increasing.
METHODS
To clarify the role of the tissue inhibitor of matrix metaloproteinase-2 (TIMP-2) in this event, we performed immunohistochemistry, immunoblotting and immunoassay of matrix metalloproteinase-9 (MMP-9) and TIMP-2 in the serum and heart tissue of mice, which were inoculated with 4000 plaque-forming units of coxsackie B virus.
RESULTS
The MMP-9 was expressed in damaged cardiomyocytes, and the TIMP-2 was expressed in mainly interstitial connective tissue between cardiac muscle bundles by immunohistochemistry. The level of serum MMP-9 was higher in the complicated than non-complicated group (p<0.001), but the level of TIMP-2 was much lower in complicated than non-complicated group (p<0.05). These findings were similar to the results of immunohistochemistry and immunoblotting in tissues.
CONCLUSIONS
These results suggest that an imbalance in the level of MMP-9 and its inhibitor might activate cardiac complication in viral myocarditis.

Cytologic Features of Benign Phyllodes Tumors as Compared to Fibroadenomas of the Breast.: Jae Hee Suh, Gyung Yub Gong, Jeong Mi park, Sei Hyun Ahn, On Ja Kim; Korean J Cytopathol. 1996;7(2):151-156.

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Abstract PDF: Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA)smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.

Cytologic Features of Metastatic Melanoma.: Jae Hee Suh, Joo Ryung Huh, Gyung Yub Gong; Korean J Cytopathol. 1996;7(2):185-191.

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Abstract PDF: Metastatic melanoma is often difficult to diagnose morphologically. However, the prognostic and therapeutic decision in cases of metastatic melanoma depends upon the morphologic documentation of the metastatic disease, which may rapidly and accurately be done by cytologic methods such as aspiration cytology of clinically suspicious lesion. Cytological features of 12 metastatic melanoma are described. Evaluation for melanin pigment, background composition, cytoplasmic vacuoles, intranuclear inclusions, bi or multinucleated cells, eccentric nuclei, nucleoli, and degree of cellular cohesion were made. the presence of melanin pigment, prominent nucleoli, intranuclear cytoplasmic inclusions, lack of cell cohesion, and eccentric nuclei are the important and useful cytologic features in the diagnosis of metastatic melanoma. Bior multinucleated cells, cytoplasmic vacuoles, and bloody background are also frequently found in smears from metastatic melanoma.

Cytologic Analysis of Malignant Tumor Cells in Cerebrospinal Fluid.: Jae Hee Suh, Gyungyub Gong, Shin Kwang Khang, On Ja Kim; Korean J Cytopathol. 1998;9(1):21-28.

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Abstract PDF: Cytologic evaluation of cerebrospinal fluid(CSF) is an effective tool in diagnosing many disorders involving the central nervous system(CNS). CSF examination has been found to be of particular value in the diagnosis of metastatic carcinoma, lymphomatous or leukemic involvement of CNS and certain primary CNS tumors. As a survey of metastatic tumors to CSF and an evaluation of the preparation techniques increasing cellular yield in our laboratory, 713 CSF specimens examined between July 1995 and April 1997(1 year 10 months), were reviewed. There were 75 positive and 5 suspicious cases, the latter have had no evidence of tumors clinically. Primary tumors of 75 positive cases were classified as follows; 4(5.3%) as primary brain tumors, 40(53.3%) as secondary carcinomas, 13(17.3%) as leukemias, and 18 (24.0%) as lymphomas. The most common primary site of metastatic carcinomas was the lung in 17 cases(42.5%) followed by the stomach in 13(32.5%), breast in 8 (20.0%), and unknown primary in 2(5.0%). Four primary brain tumors were 3 cerebellar medulloblastomas and a supratentorial primitive neuroectodermal tumor (PNET). All 40 metastatic carcinomas were adenocarcinoma presented as single cells or cell clusters. Although signet ring cells were frequent in the cases of gastric primary cancers, no significant cytologic differences according to the primary site were observed. The cytologic features of leukemia and lymphoma were characterized by hypercellular smears presenting as individual atypical cells with increased N/C ratio, presence of nucleoli, and nuclear protrusions. In medulloblastomas and PNET, the principal cytologic findings were small undifferentiated cells arranged singly or in loose clusters with occasional rosettoid features. This study suggests that the CSF cytology is useful in the diagnosis of malignancy, especially metastatic extracranial tumors and the diagnostic accuracy can be improved by increasing cellular yield using cytocentrifuge.

Case Report

Fine Needle Aspiration Cytology of Cystic Hypersecretory Intraductal Carcinoma of the Breast: Report of Two Cases.: Hee Jeong Cha, Dae Woon Eom, Jae Hee Suh; Korean J Cytopathol. 2003;14(1):22-26.

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Abstract: Cystic hypersecretory carcinoma of the breast is a rare variant of ductal carcinoma of breast, first described in 1984 by Rosen and Scott. Histologically, it is characterized by the formation of dilated ducts and cysts containing an eosinophilic secretory product resembling thyroid colloid. Cytologic findings show a few clusters of atypical ductal epithelial cells in amorphous proteinaceous material with cracking artifact. Differential diagnosis include mucinous carcinoma and benign mucocele-like tumor. We present two cases of fine needle aspiration cytology of cystic hypersecretory intraductal carcinoma of the breast with a review of the literature.

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